Come as You Are: the bestselling guide to the new science that will transform your sex life

By Emily Nagoski

A NEW YORK TIMES BESTSELLER

An essential exploration of women’s sexuality that will radically transform your sex life into one filled with confidence and joy.

After all the books that have been written about sex, all the blogs and TV shows and radio Q&As, how can it be that we all still have so many questions? The frustrating reality is that we’ve been lied to — not deliberately, it’s no one’s fault, but still. We were told the wrong story.

Come as You Are reveals the true story behind female sexuality, uncovering the little-known science of what makes us tick and, more importantly, how and why. Sex educator Dr Emily Nagoski debunks the common sexual myths that are making women (and some men!) feel inadequate between the sheets.

Underlying almost all of the questions we still have about sex is the common worry: ‘Am I normal?’ This book answers with a resounding Yes! We are all different, but we are all normal — and once we learn this, we can create for ourselves better sex and more profound pleasure than we ever thought possible.

PRAISE FOR EMILY NAGOSKI

‘As a literary work, Nagoski’s book deserves plaudits for the rare achievement of merging pop science and the sexual self-help genre in prose that’s not insufferably twee … “You are normal!” doesn’t sound much like a battlecry, but in a world keen to sexually homogenise women from the gap of their thighs to the shape of their mons pubis, the sentiment lands like a bomb.’ The Guardian

‘Come As You Are screams female empowerment loud and proud.’ The Independent

• Language: English
• Publisher: Scribe Publications
• Release date: Apr 9, 2015
• ISBN: 9781925113839

Emily Nagoski

Emily Nagoski is the award-winning author of the New York Times bestseller Come as You Are: The Surprising New Science That Will Transform Your Sex Life, and the coauthor of Burnout: The Secret to Unlocking the Stress Cycle. She has an MS in counseling and a PhD in health behavior, both from Indiana University.

Book preview

COME AS YOU ARE

EMILY NAGOSKI is director of Wellness Education and lecturer at Smith College, where she teaches women’s sexuality. She has a PhD in health behaviour with a doctoral concentration in human sexuality from Indiana University (IU), and a master’s degree (also from IU) in counseling, with a clinical internship at the Kinsey Institute Sexual Health Clinic. She also has a BA in psychology, with minors in cognitive science and philosophy, from the University of Delaware.

While at IU, Emily worked as an educator and docent at the Kinsey Institute for Research in Sex, Gender, and Reproduction. She also taught graduate and undergraduate classes in human sexuality, relationships and communication, stress management, and sex education.

She is the author of three guides for Ian Kerner’s goodinbed.com, including Guide to Female Orgasms, and she writes the popular sex blog thedirtynormal.com.

Emily lives in western Massachusetts with two dogs, two cats, and a cartoonist.

Scribe Publications

18–20 Edward St, Brunswick, Victoria 3056, Australia

2 John St, Clerkenwell, London, WC1N 2ES, United Kingdom

First published by Scribe 2015

This edition published by arrangement with Simon & Schuster Paperbacks, a division of Simon & Schuster, Inc., New York.

Copyright © Emily Nagoski, PhD, 2015

Illustrated by Erika Moen

All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publishers of this book.

National Library of Australia

Cataloguing-in-Publication data

Nagoski, Emily, author

Come as You Are: the surprising new science that will transform your sex life.

9781925106596 (AUS edition)

9781925228014 (UK edition)

9781925113839 (e-book)

1. Sexual excitement. 2. Sex instruction for women. 3. Women–Sexual behavior.

613.96

scribepublications.com.au

scribepublications.co.uk

contents

Introduction: Yes, You Are Normal

The True Story of Sex

The Organization of This Book

A Couple of Caveats

If You Feel Broken, or Know Someone Who Does

part 1 the (not-so-basic) basics

1. Anatomy: No Two Alike

The Beginning

The Clit, the Whole Clit, and Nothing but the Clit

Meet Your Clitoris

Lips, Both Great and Small

Hymen Truths

A Word on Words

The Sticky Bits

Intersex Parts

Why It Matters

Change How You See

A Better Metaphor

What It Is, Not What It Means

2. The Dual Control Model: Your Sexual Personality

Turn On the Ons, Turn Off the Offs

Arousability

What Medium Means

Different for Girls . . . but Not Necessarily

What Turns You On?

All the Same Parts, Organized in Different Ways

Can You Change Your SIS or SES?

3. Context: And the One Ring (to Rule Them All) in Your Emotional Brain

Sensation in Context

Sex, Rats, and Rock ’n’ Roll

Your Emotional One Ring

You Can’t Make Them

Is Something Wrong with Me? (Answer: Nope)

part 2 sex in context

4. Emotional Context: Sex in a Monkey Brain

The Stress Response Cycle: Fight, Flight, and Freeze

Stress and Sex

Broken Culture Broken Stress Response Cycles

Complete the Cycle!

When Sex Becomes the Lion

Sex and the Survivor

Origin of Love

The Science of Falling in Love

Attachment and Sex: The Dark Side

Attachment and Sex: Sex That Advances the Plot

Attachment Style

Managing Attachment: Your Feels as a Sleepy Hedgehog

Survival of the Social

The Water of Life

5. Cultural Context: A Sex-Positive Life in a Sex-Negative World

Three Messages

You Are Beautiful

Criticizing Yourself = Stress = Reduced Sexual Pleasure

Health at Every Size

Dirty

When Somebody Yucks Your Yum

Maximizing Yum . . . with Science! Part 1: Self-Compassion

Maximizing Yum . . . with Science! Part 2: Cognitive Dissonance

Maximizing Yum . . . with Science! Part 3: Media Nutrition

You Do You

part 3 sex in action

6. Arousal: Lubrication Is Not Causation

Measuring and Defining Nonconcordance

All the Same Parts, Organized in Different Ways: This Is a Restaurant

Nonconcordance in Other Emotions

Lubrication Error #1: Genital Response = Turned On

Lubrication Error #2: Genital Response Is Enjoying

Lubrication Error #3: Nonconcordance Is a Problem

Medicating Away the Brakes

Honey . . . I’m Nonconcordant!

Ripe Fruit

7. Desire: Actually, It’s Not a Drive

Desire = Arousal in Context

Not a Drive. For Real.

Why It Matters That It’s Not a Drive

"But Emily, Sometimes It Feels Like a Drive!"

Impatient Little Monitors

Good News! It’s Probably Not Your Hormones

More Good News! It’s Not Monogamy, Either

Isn’t It Just Culture?

It Might Be the Chasing Dynamic

Maximizing Desire . . . with Science! Part 1: Arousing the One Ring

Maximizing Desire . . . with Science! Part 2: Turning Off the Offs

Maximizing Desire . . . with Science! Part 3: Desperate Measures

Sharing Your Garden

part 4 ecstasy for everybody

8. Orgasm: The Fantastic Bonus

Nonconcordance—Now with Orgasms!

No Two Alike

All the Same Parts . . .

Your Vagina’s Okay, Either Way

The Evolution of the Fantastic Bonus

Difficulty with Orgasm

Ecstatic Orgasm: You’re a Flock!

How Do You Medicate a Flock?

Flying Toward Ecstasy

9. Meta-Emotions: The Ultimate Sex-Positive Context

Can’t Get No . . .

The Map and the Terrain

Positive Meta-Emotions Step 1: Trust the Terrain

Positive Meta-Emotions Step 2: Let Go of the Map (the Hard Part)

How to Let Go: Nonjudging

Nonjudging = Emotion Coaching

Nonjudging: Tips for Beginners

No Good Reason

Healing Trauma with Nonjudging

When Partners Dismiss!

Influencing the Little Monitor Part 1: Changing Your Criterion Velocity

Influencing the Little Monitor Part 2: Changing the Kind of Effort

Influencing the Little Monitor Part 3: Changing the Goal

To Feel Normal

This Is It

Conclusion: You Are the Secret Ingredient

Why I Wrote This Book

Where to Look for More Answers

Acknowledgments

Appendix 1: Therapeutic Masturbation

Appendix 2: Extended Orgasm

Notes

References

For my students

introduction

YES, YOU ARE NORMAL

To be a sex educator is to be asked questions. I’ve stood in college dining halls with a plate of food in my hands answering questions about orgasm. I’ve been stopped in hotel lobbies at professional conferences to answer questions about vibrators. I’ve sat on a park bench, checking social media on my phone, only to find questions from a stranger about her asymmetrical genitals. I’ve gotten emails from students, from friends, from their friends, from total strangers about sexual desire, sexual arousal, sexual pleasure, sexual pain, orgasm, fetishes, fantasies, bodily fluids, and more.

Questions like . . .

• Once my partner initiates, I’m into it, but it seems like it never even occurs to me to be the one to start things. Why is that?

• My boyfriend was like, You’re not ready, you’re still dry. But I was so ready. So why wasn’t I wet?

• I saw this thing about women who can’t enjoy sex because they worry about their bodies the whole time. That’s me. How do I stop doing that?

• I read something about women who stop wanting sex after a while in a relationship, even if they still love their partner. That’s me. How do I start wanting sex with my partner again?

• I think maybe I peed when I had an orgasm . . . ?

• I think maybe I’ve never had an orgasm . . . ?

Under all these questions, there’s really just one question:

Am I normal?

(The answer is nearly always: Yes.)

This book is a collection of answers. They’re answers that I’ve seen change women’s lives, answers informed by the most current science and by the personal stories of women whose growing understanding of sex has transformed their relationships with their own bodies. These women are my heroines, and I hope that by telling their stories, I’ll empower you to follow your own path, to reach for and achieve your own profound and unique sexual potential.

the true story of sex

After all the books that have been written about sex, all the blogs and TV shows and radio Q&As, how can it be that we all still have so many questions?

Well. The frustrating reality is we’ve been lied to—not deliberately, it’s no one’s fault, but still. We were told the wrong story.

For a long, long time in Western science and medicine, women’s sexuality was viewed as Men’s Sexuality Lite—basically the same but not quite as good.

For instance, it was just sort of assumed that since men have orgasms during penis-in-vagina sex (intercourse), women should have orgasms with intercourse too, and if they don’t, it’s because they’re broken.

In reality, about 30 percent of women orgasm reliably with intercourse. The other 70 percent sometimes, rarely, or never orgasm with intercourse, and they’re all healthy and normal. A woman might orgasm lots of other ways—manual sex, oral sex, vibrators, breast stimulation, toe sucking, pretty much any way you can imagine—and still not orgasm during intercourse. That’s normal.

It was just assumed, too, that because a man’s genitals typically behave the way his mind is behaving—if his penis is erect, he’s feeling turned on—a woman’s genitals should also match her emotional experience.

And again, some women’s do, many don’t. A woman can be perfectly normal and healthy and experience arousal nonconcordance, where the behavior of her genitals (being wet or dry) may not match her mental experience (feeling turned on or not).

And it was also assumed that because men experience spontaneous, out-of-the-blue desire for sex, women should also want sex spontaneously.

Again it turns out that’s true sometimes, but not necessarily. A woman can be perfectly normal and healthy and never experience spontaneous sexual desire. Instead, she may experience responsive desire, in which her desire emerges only in a highly erotic context.

In reality, women and men are different.

But wait. Women and men both experience orgasm, desire, and arousal, and men, too, can experience responsive desire, arousal nonconcordance, and lack of orgasm with penetration. Women and men both can fall in love, fantasize, masturbate, feel puzzled about sex, and experience ecstatic pleasure. They both can ooze fluids, travel forbidden paths of sexual imagination, encounter the unexpected and startling ways that sex shows up in every domain of life—and confront the unexpected and startling ways that sex sometimes declines, politely or otherwise, to show up.

So . . . are women and men really that different?

The problem here is that we’ve been taught to think about sex in terms of behavior, rather than in terms of the biological, psychological, and social processes underlying the behavior. We think about our physiological behavior—blood flow and genital secretions and heart rate. We think about our social behavior—what we do in bed, whom we do it with, and how often. A lot of books about sex focus on those things; they tell you how many times per week the average couple has sex or they offer instructions on how to have an orgasm, and they can be helpful.

But if you really want to understand human sexuality, behavior alone won’t get you there. Trying to understand sex by looking at behavior is like trying to understand love by looking at a couple’s wedding portrait . . . and their divorce papers. Being able to describe what happened—two people got married and then got divorced—doesn’t get us very far. What we want to know is why and how it came to be. Did our couple fall out of love after they got married, and that’s why they divorced? Or were they never in love but were forced to marry, and finally became free when they divorced? Without better evidence, we’re mostly guessing.

Until very recently, that’s how it’s been for sex—mostly guessing. But we’re at a pivotal moment in sex science because, after decades of research describing what happens in human sexual response, we’re finally figuring out the why and how—the process underlying the behavior.

In the last decade of the twentieth century, researchers Erick Janssen and John Bancroft at the Kinsey Institute for Research in Sex, Gender, and Reproduction developed a model of human sexual response that provides an organizing principle for understanding the true story of sex. According to their dual control model, the sexual response mechanism in our brains consists of a pair of universal components—a sexual accelerator and sexual brakes—and those components respond to broad categories of sexual stimuli—including genital sensations, visual stimulation, and emotional context. And the sensitivity of each component varies from person to person.

The result is that sexual arousal, desire, and orgasm are nearly universal experiences, but when and how we experience them depends largely on the sensitivities of our brakes and accelerator and on the kind of stimulation they’re given.

This is the mechanism underlying the behavior—the why and the how. And it’s the rule that governs the story I’ll be telling in this book: We’re all made of the same parts, but in each of us, those parts are organized in a unique way that changes over our life span.

No organization is better or worse than any other, and no phase in our life span is better or worse than any other; they’re just different. An apple tree can be healthy no matter what variety of apple it is—though one variety may need constant direct sunlight and another might enjoy some shade. And an apple tree can be healthy when it’s a seed, when it’s a seedling, as it’s growing, and as it fades at the end of the season, as well as when, in late summer, it is laden with fruit. But it has different needs at each of those phases in its life.

You, too, are healthy and normal at the start of your sexual development, as you grow, and as you bear the fruits of living with confidence and joy inside your body. You are healthy when you need lots of sun, and you’re healthy when you enjoy some shade. That’s the true story. We are all the same. We are all different. We are all normal.

the organization of this book

The book is divided into four parts: (1) The (Not-So-Basic) Basics; (2) Sex in Context; (3) Sex in Action; and (4) Ecstasy for Everybody. The three chapters in the first part describe the basic hardware you were born with—a body, a brain, and a world. In chapter 1, I talk about genitals—their parts, the meaning we impose on those parts, and the science that proves definitively that yes, your genitals are perfectly healthy and beautiful just as they are. Chapter 2 details the sexual response mechanism in the brain—the dual control model of inhibition and excitation, or brakes and accelerator. Then in chapter 3, I introduce the ways that your sexual brakes and accelerator interact with the many other systems in your brain and environment, to shape whether a particular sensation or person turns you on, right now, in this moment.

In the second part of the book, Sex in Context, we think about how all the basic hardware functions within the context of your actual life—your emotions, your relationship, your feelings about your body, and your attitudes toward sex. Chapter 4 focuses on two primary emotional systems, love and stress, and the surprising and contradictory ways they can influence your sexual responsiveness. Then chapter 5 describes the cultural forces that shape and constrain sexual functioning, and how you can maximize the good things about this process and overcome the destructive things. What we’ll learn is that context—your external circumstances and your present mental state—is as crucial to your sexual wellbeing as your body and brain. Master the content in these chapters and your sexual life will transform—along with, quite possibly, the rest of your life.

The third part of the book, Sex in Action, is about sexual response itself, and I bust two long-standing and dangerous myths. Chapter 6 lays out the evidence that sexual arousal may or may not have anything to do with what’s happening in your genitals. This is where we learn why arousal nonconcordance, which I mentioned earlier, is normal and healthy. And after you read chapter 7, you will never again hear someone say sex drive without thinking to yourself, Ah, but sex is not a drive. In this chapter I explain how responsive desire works. If you (or your partner) have ever experienced a change in your interest in sex—increase or decrease—this is an important chapter for you.

And the fourth part of the book, Ecstasy for Everybody, explains how to make sex entirely yours, which is how you create peak sexual ecstasy in your life. Chapter 8 is about orgasms—what they are, what they’re not, how to have them, and how to make them like the ones you read about, the ones that turn the stars into rainbows. And finally, in Chapter 9, I describe the single most important thing you can do to improve your sex life. But I’ll give it away right now: It turns out what matters most is not the parts you are made of or how they are organized, but how you feel about those parts. When you embrace your sexuality precisely as it is right now, that’s the context that creates the greatest potential for ecstatic pleasure.

Several chapters include worksheets or other interactive activities and exercises. A lot of these are fun—like in chapter 3, I ask you to think about times when you’ve had great sex and identify what aspects of the context helped to make that sex great. All of them turn the science into something practical that can genuinely transform your sex life.

Throughout the book, you’ll follow the stories of four women—Olivia, Merritt, Camilla, and Laurie. These women don’t exist as individuals; they’re composites, integrating the real stories of the many women I’ve taught, talked with, emailed, and supported in my two decades as a sex educator. You can imagine each woman as a collage of snapshots—the face from one photograph, the arms from another, the feet from a third . . . each part represents someone real, and the collection hangs together meaningfully, but I’ve invented the relationships that the parts have to each other.

I’ve chosen to construct these composites rather than tell the stories of specific women for two reasons. First, people tell me their stories in confidence, and I want to protect their identities, so I’ve changed details in order to keep their story their story. And second, I believe I can describe the widest possible variety of women’s sexual experiences by focusing not on specific stories of one individual woman but on the larger narratives that contain the common themes I’ve seen in all these hundreds of women’s lives.

And finally, at the end of each chapter you’ll find a tl;dr list—too long; didn’t read, the blunt Internet abbreviation that means, Just get to the point. Each tl;dr list briefly summarizes the four most important messages in the chapter. If you find yourself thinking, My friend Alice should totally read this chapter! or I really wish my partner knew this, you might start by showing them the tl;dr list.* Or, if you’re like me and get too excited about these ideas to keep them to yourself, you can follow your partner around the house, reading the tl;dr list out loud and saying, See, honey, arousal nonconcordance is a thing! or It turns out I have responsive desire! or You give me great context, sweetie!

[* I’ll use they as a singular pronoun, rather than he or she throughout the book. It’s simpler, as well as more inclusive of folks outside the gender binary.]

a couple of caveats

First, most of the time when I say women in this book, I mean people who were born in female bodies, were raised as girls, and now have the social role and psychological identity of woman. There are plenty of women who don’t fit one or more of those characteristics, but there’s too little research on trans* and genderqueer sexual functioning for me to say with certainty whether what’s true about cisgender women’s sexual wellbeing is also true for trans* folks. I think it probably is, and as more research emerges over the coming decade we’ll find out, but in the meantime I want to acknowledge that this is basically a book about cisgender women.

And if you don’t know what any of that means, don’t worry about it.

Second, I am passionate about the role of science in promoting women’s sexual wellbeing, and I have worked hard in this book to encapsulate the research in the service of teaching women to live with confidence and joy inside their bodies. But I’ve been very intentional about the empirical details I’ve included or excluded. I asked myself, Does this fact help women have better sex lives, or is it just a totally fascinating and important empirical puzzle?

And I cut the puzzles.

I kept only the science that has the most immediate relevance in women’s everyday lives. So what you’ll find in these pages isn’t the whole story of women’s sexuality—I’m not sure the whole story would actually fit in one book. Instead, I’ve included the parts of the story that I’ve found most powerful in my work as a sex educator, promoting women’s sexual wellbeing, autonomy, and pleasure.

The purpose of this book is to offer a new, science-based way of thinking about women’s sexual wellbeing. Like all new ways of thinking, it opens up a lot of questions and challenges much preexisting knowledge. If you want to dive deeper, you’ll find references in the notes, along with details about my process for boiling down a complex and multifaceted body of research into something practical.

if you feel broken, or know someone who does

One more thing before we get into chapter 1. Remember how I said we’ve all been lied to, but it’s no one’s fault? I want to take a moment to recognize the damage done by that lie.

So many women come to my blog or to my class or to my public talks convinced that they are sexually broken. They feel dysfunctional. Abnormal. And on top of that, they feel anxious, frustrated, and hopeless about the lack of information and support they’ve received from medical professionals, therapists, partners, family, and friends.

Just relax, they’ve been told. Have a glass of wine.

Or, Women just don’t want sex that much. Get over it.

Or, Sometimes sex hurts—can’t you just ignore it?

I understand the frustration these women experience, and the despair—and in the second half of the book I talk about the neurological process that traps people in frustration and despair, shutting them off from hope and joy, and I describe science-based ways to get out of the trap.

Here’s what I need you to know right now: The information in this book will show you that whatever you’re experiencing in your sexuality—whether it’s challenges with arousal, desire, orgasm, pain, no sexual sensations—is the result of your sexual response mechanism functioning appropriately . . . in an inappropriate world. You are normal; it is the world around you that’s broken.

That’s actually the bad news.

The good news is that when you understand how your sexual response mechanism works, you can begin to take control of your environment and your brain in order to maximize your sexual potential, even in a broken world. And when you change your environment and your brain, you can change—and heal—your sexual functioning.

This book contains information that I have seen transform women’s sexual wellbeing. I’ve seen it transform men’s understanding of their women partners. I’ve seen same-sex couples look at each other and say, "Oh. So that’s what was going on. Students, friends, blog readers, and even fellow sex educators have read a blog post or heard me give a talk and said, Why didn’t anyone tell me this before? It explains everything!"

I know for sure that what I’ve written in this book can help you. It may not be enough to heal all the wounds inflicted on your sexuality by a culture in which it sometimes feels nearly impossible for a woman to do sexuality right, but it will provide powerful tools in support of your healing.

How do I know?

Evidence, of course!

At the end of one semester, I asked my 187 students to write down one really important thing they learned in my class. Here’s a small sample of what they wrote:

I am normal!

I AM NORMAL

I learned that everything is NORMAL, making it possible to go through the rest of my life with confidence and joy.

I learned that I am normal! And I learned that some people have spontaneous desire and others have responsive desire and this fact helped me really understand my personal life.

Women vary! And just because I do not experience my sexuality in the same way as many other women, that does not make me abnormal.

Women’s sexual desire, arousal, response, etc., is incredibly varied.

The one thing I can count on regarding sexuality is that people vary, a lot.

That everyone is different and everything is normal; no two alike.

No two alike!

And many more. More than half of them wrote some version of I am normal.

I sat in my office and read those responses with tears in my eyes. There was something urgently important to my students about feeling normal, and somehow my class had cleared a path to that feeling.

The science of women’s sexual wellbeing is young, and there is much still to be learned. But this young science has already discovered truths about women’s sexuality that have transformed my students’ relationships with their bodies—and it has certainly transformed mine. I wrote this book to share the science, stories, and sex-positive insights that prove to us that, despite our culture’s vested interest in making us feel broken, dysfunctional, unlovely, and unlovable, we are in fact fully capable of confident, joyful sex.

The promise of Come as You Are is this: No matter where you are in your sexual journey right now, whether you have an awesome sex life and want to expand the awesomeness, or you’re struggling and want to find solutions, you will learn something that will improve your sex life and transform the way you understand what it means to be a sexual being. And you’ll discover that, even if you don’t yet feel that way, you are already sexually whole and healthy.

The science says so.

I can prove it.

part 1

the (not-so-basic) basics

one

anatomy

NO TWO ALIKE

Olivia likes to watch herself in the mirror when she masturbates.

Like many women, Olivia masturbates lying on her back and rubbing her clitoris with her hand. Unlike many women, she props herself up on one elbow in front of a full-length mirror and watches her fingers moving in the folds of her vulva.

I started when I was a teenager, she told me. I had seen porn on the Internet, and I was curious about what I looked like, so I got a mirror and started pulling apart my labia so I could see my clit, and what can I say? It felt good, so I started masturbating.

It’s not the only way she masturbates. She also enjoys the pulse spray on her showerhead, she has a small army of vibrators at her command, and she spent several months teaching herself to have breath orgasms, coming without touching her body at all.

This is the kind of thing women tell you when you’re a sex educator.

She also told me that looking at her vulva convinced her that her sexuality was more like a man’s, because her clitoris is comparatively large—like a baby carrot, almost—which, she concluded, made her more masculine; it must be bigger because she had more testosterone, which in turn made her a horny lady.

I told her, Actually there’s no evidence of a relationship between an adult woman’s hormone levels, genital shape or size, and sexual desire or response.

Are you sure about that? she asked.

Well, some women have ‘testosterone-dependent’ desire, I said, pondering, which means they need a certain very low minimum of T, but that’s not the same as ‘high testosterone.’ And the distance between the clitoris and the urethra predicts how reliably orgasmic a woman is during intercourse, but that’s a whole other thing. I’d be fascinated to see a study that directly asked the question, but the available evidence suggests that variation in women’s genital shapes, sizes, and colors doesn’t predict anything in particular about her level of sexual interest.

Oh, she said. And that single syllable said to me: Emily, you have missed the point.

Olivia is a psychology grad student—a former student of mine, an activist around women’s reproductive health issues, and now doing her own research, which is how we got started on this conversation—so I got excited about the opportunity to talk about the science. But with that quiet, Oh, I realized that this wasn’t about the science for Olivia. It was about her struggle to embrace her body and her sexuality just as it is, when so much of her culture was trying to convince her there is something wrong with her.

So I said, You know, your clitoris is totally normal. Everyone’s genitals are made of all the same parts, just organized in different ways. The differences don’t necessarily mean anything, they’re just varieties of beautiful and healthy. Actually, I continued, that could be the most important thing you’ll ever learn about human sexuality.

Really? she asked. Why?

This chapter is the answer to that question.

Medieval anatomists called women’s external genitals the pudendum, a word derived from the Latin pudere, meaning to make ashamed. Our genitalia were thus named from the shamefacedness that is in women to have them seen. ¹

Wait: what?

The reasoning went like this: Women’s genitals are tucked away between their legs, as if they wanted to be hidden, whereas male genitals face forward, for all to see. And why would men’s and women’s genitals be different in this way? If you’re a medieval anatomist, steeped in a sexual ethic of purity, it’s because: shame.

Now, if we assume shame isn’t really why women’s genitals are under the body—and I hope it’s eye-rollingly obvious that it’s not—why, biologically, are male genitals in front and female genitals underneath?

The answer is, they’re actually not! The female equivalent to the penis—the clitoris—is positioned right up front, in the equivalent location to the penis. It’s less obvious than the penis because it’s smaller—and it’s smaller not because it’s shy or ashamed, but because females don’t have to transport our DNA from inside our own bodies to inside someone else’s body. And the female equivalent of the scrotum—the outer labia—is also located in very much the same place as the scrotum, but because the female gonads (the ovaries) are internal, rather than external like the testicles, the labia don’t extend much past the body, so they’re less obvious. Again, the ovaries are not internal because of shame, but because we’re the ones who get pregnant.

In short, female genitals appear hidden only if you look at them through the lens of cultural assumptions rather than through the eyes of biology.

We’ll see this over and over again throughout the book: Culture adopts a random act of biology and tries to make it Meaningful, with a capital Mmmh. We metaphorize genitals, seeing what they are like rather than what they are, we superimpose cultural Meaning on them, as Olivia superimposed the meaning of masculine on her largish clitoris, to conclude that her anatomy had some grand meaning about her as sexually masculine.

When you can see your body as it is, rather than what culture proclaims it to Mean, then you experience how much easier it is to live with and love your genitals, along with the rest of your sexuality, precisely as they are.

So in this chapter, we’ll look at our genitals through biological eyes, cultural lenses off. First, I’ll walk you through the ways that male and female genitals are made of exactly the same parts, just organized in different ways. I’ll point out where the biology says one thing and culture says something else, and you can decide which makes more sense to you. I’ll illustrate how the idea of all the same parts, organized in different ways extends far beyond our anatomy to every aspect of human sexual response, and I’ll argue that this might be the most important thing you’ll ever learn about your sexuality.

In the end, I’ll offer a new central metaphor to replace all the wacky, biased, or nonsensical ones that culture has tried to impose on women’s bodies. My goal in this chapter is to introduce an alternative way of thinking about your body and your sexuality, so that you can relate to your body on its own terms, rather than on terms somebody else chose for you.

the beginning

Imagine two fertilized eggs that have just implanted in a uterus. One is XX—genetically female—and the other is XY—genetically male. Fraternal twins, a sister and a brother. Faces, fingers, and feet—the siblings will develop all the same body parts, but the parts will be organized differently, to give them the individual bodies that will be instantly distinguishable from each other as they grow up. And just as their faces will each have two eyes, one nose, and a mouth, all arranged in more or less the same places, so their genitals will have all the same basic elements, organized in roughly the same way. But unlike their faces and fingers and feet, their genitals will develop before birth into configurations that their parents will automatically recognize as male or female.

Here’s how it happens. About six weeks after the fertilized egg implants in the uterus, there is a wash of masculinizing hormones. The male blastocyst (a group of cells that will form the embryo) responds to this by developing its prefab universal genital hardware into the male configuration of penis, testicles, and scrotum. The female blastocyst does not respond to the hormone wash at all, and instead develops its prefab universal genital hardware into the default, female configuration of clitoris, ovaries, and labia.

Welcome to the wonderful world of biological homology.

Homologues are traits that have the same biological origins, though they may have different functions. Each part of the external genitalia has a homologue in the other sex. I’ve mentioned two of them already: Both male and female genitals have a round-ended, highly sensitive, multichambered organ to which blood flows during sexual arousal. On females, it’s the clitoris; on males, it’s the penis. And each has an organ that is soft, stretchy, and grows coarse hair after puberty. On females, it’s the outer lips (labia majora); on males, it’s the scrotum. These parts don’t just look superficially alike; they are developed from the equivalent fetal tissue.

Reviews for Come as You Are

[johnverdon · Rating: 5 out of 5 stars]

This is a wonderful book - that I wish had been around when I was a young man. This is a science grounded and practical account of female sexuality that all men should inform all men as well. If I had read this as a younger man - my relationships and my masculinity would have all been enriched.

[bexaplex · Rating: 5 out of 5 stars]

This book is fantastic, and way out in front of its peer group (Bonk, I Love Female Orgasm, etc.). Nagoski is an astute observer, a compelling storyteller and a brilliant, curious thinker about female sexuality. I wish this book had been published 10 years ago :)

[pepperwings · Rating: 3 out of 5 stars]

This *almost* gets 4 stars, but not quite, I knew most of the information in here, and I felt like she talked down to the reader somewhat. However, this is really excellent in many ways, and if you *don't* know these things, this would be an easy read to get you there. So I would recommend it.

[shannonrose4 · Rating: 5 out of 5 stars]

"If you feel broken, or know someone who does... we've all been lied to but its no one's fault.." This is the page heading that this book fell open to when I first opened this Amazing book. This is the book I wish I had had years ago and should be part of Everyones sex education. This book won't just change your sex life, it will change your whole life forever.

Special P.S. to the author: Thanks & Wow.

[krisbee-1 · Rating: 4 out of 5 stars]

Very informative and well written in an engaging style that is easily understood. Explains mind and body interactions with in depth instruction on body parts and functions. The chapter on stress is a must read.

[wyvernfriend · Rating: 5 out of 5 stars]

This was an excellent read, full of interesting advice on how to deal with sex and sexuality issues and should be encouraged reading for all teens and most adults as part of a pre-marriage course. Her mantra was that everyone is an individual and that your mileage may vary. Important things to realise when the world presents everybody as one type.I found it very good food for thought.

[lycomayflower · Rating: 4 out of 5 stars]

Accessible and informative discussion of female sexuality, what the science says about how it works, how it differs from male sexuality, how the brain and the emotions are involved, and what to do if things aren't working as you might like. Fascinating, fascinating science here, and absolutely worth a read whether or not you think your sex life needs transforming (I think some of the cover copy sells the book short, actually; it reads a bit like this is a self-help book, and while it has those aspects, it's also great lay science about sexuality and the way emotions function in human beings). Some of the presentation is a little touchy-feely for me, but the book is highly readable, and the sex-positive, body-positive, woman-positive message is awesome. Recommended. See if you can find an interview online with Nagoski for a taste of what the book's like. She's great in person, and catching a snippet of one was what lead me to pick up the book.

[swampygirl-1 · Rating: 5 out of 5 stars]

A very excellent book. I thought I knew just about everything that popular culture got wrong about sex, it turns out my knowledge was pretty much limited to the facts. Emaily Nagoski's book was not only super easy to read, it also helped me to figure out what was holding back my own sex drive and how to better think about sexuality in general.

[gwendydd · Rating: 5 out of 5 stars]

This should be required reading for every woman, whether she is happy with her sexual well-being or not, whether she is in a sexual relationship or not. It is full of really fascinating information about how female bodies work. It is also full of good information about mental health in general. Nagoski makes it clear that most of what society has told us about sex and how our bodies work is wrong, and she does an amazing job of convincing readers that they are healthy and amazing.

[thewestwing-864351 · Rating: 4 out of 5 stars]

Thought this was really insightful and obviously well researched. While it is marketed at women, it would be great if more men read it as I think societal thinking will only change if men push for it as well.

[zoes_human · Rating: 5 out of 5 stars]

This is what all self-help should be. Science-informed, inclusive guidance by an experienced expert in the field which has absolutely no sales pitch. The audio narration is amazing by the way. Emily Nagoski's genuine passion for her topic and decades of experience as an educator really shines in it.WHO THIS BOOK IS DEFINITELY FOR: Cis-women who would like to improve their sex lives, cis-women who worked really hard to get where they want in their sex lives but would like to know how the fuck it worked, men and women who would like to be better partners for female partners, people who are just interested in sex as a topic, and anyone interested in concrete, actionable information on how to "manage your stress" or "sit with your emotions" that doesn't necessarily involve money.WHO THIS BOOK MIGHT BE FOR: Trans-women in any of the above categories. The author believes that much of what is in the book does indeed apply to all women; however, as sadly lacking as proper research into sexuality for cis-women is, the research for trans-women is even more lackingWHO THIS BOOK IS ABSOLUTELY NOT FOR: Your asexual friend that you want to "help". They're fine. You, on the other hand, definitely need this book.

[milliehennessy · Rating: 5 out of 5 stars]

This is a bit more of a personal review for me, so skip this if you're not interested - I picked up this book after my therapist recommended it. Sexuality and understanding my body are something I've recently come to realize I've always struggled with. This book is full of science and has really given me understanding about the way I work and helped me see some of the reasons as to why I feel the way I do currently. It's a lot to take in and a book I'd recommend that you be prepared to highlight and annotate (yes, really!) - my own copy is tabbed and highlighted so that I can revisit some especially pertinent sections and better absorb them. Each section has some activities you can complete right in the book as well. If you're struggling to understand your sex drive, whether it be high or low, I think you'll find this book useful. In fact, you'll learn that sex isn't even a drive! I'm not one of those people to ever feel like a book is life-changing, but this one comes pretty close. I don't read much in the way of self-help, but this book was so helpful that it makes me wonder what else is out there. Nagoski explains the science she's studied in a very relatable way. I would especially recommend this if you've ever felt "broken" when it comes to desire, drive, etc. It was incredibly important to me to be able to understand not only the way I feel, but that the way I feel isn't broken or wrong. It's normal and understandable.I'm not yet sure how I'll apply all I've learned, but I'm so glad I read this book.

[rivkat_2 · Rating: 4 out of 5 stars]

The good: the book is inclusive; the author makes clear that she’s writing for cis women but is aware of the variety among women. Everyone is normal, she insists, and tries to convince the reader that no one is broken or unhealthy unless they’re actually experiencing pain. The concepts are clearly stated, even repeated a bunch of times, which is probably useful when you’re dealing with painful topics. Nagoski has a slightly different take on recent sexuality research than other popular works; she contends that when studies show that women are “aroused” by images of all sorts of sexual activity regardless of their sexual orientation, even images of bonobos mating, other commentary has mistaken a physical response for arousal. That response, she says, represents awareness of sexual relevance, but true arousal is in the head. She calls this nonconcordant desire, where the body and the mind aren’t quite in sync, at least in the male-oriented model of sexuality that predominates. Simply stated, not getting wet doesn’t mean you’re not aroused, and getting wet doesn’t mean you want sex, just that your body has noticed a sexually relevant situation. Some men and many women experience nonconcordant desire.Nagoski structures her advice around the idea of a sexual accelerator and brakes. The accelerator leads to desire for sex and the brakes lead to non-desire or even revulsion. Stepping hard on the accelerator won’t help unless you’ve let up on the brakes. Thus, she suggests that people identify where their perceived problems come from—is it stress and other barriers braking a level of desire, or is it that it’s hard to get started? Relatedly, she argues that having responsive desire is normal: if you only want or enjoy sex after it’s been initiated, and don’t “naturally” desire it yourself, that’s fine.The meh: the language is colloquial, extremely so. You have to be comfortable with reading about your “feels,” not your feelings.The not so good: despite the broad, accepting language, the advice all assumes that the reader has previously had satisfying sex with a partner and is trying to get back to that. Thus, the exercises center around figuring out what worked before and what elements need to be restored.

[willszal-1 · Rating: 3 out of 5 stars]

This book is written primarily for cisgender women. As a cisgender heterosexual male, I found it insightful.NormalThe first thing I was struck by in the book was Nagoski’s extensive and creative use of the term “normal,” and the gender-stereotypical insecurity its usage implies. “Normal” is generally used in a statistical sense. Here it is used to be psychologically comforting and statistically meaningless, as Nagoski relentlessly insists that everyone is “normal.” If we set aside this unusual use of the word, we’re still confronted with a question: why would someone want to be normal? Personally, I would much rather be exceptional, noteworthy, interesting, or even unusual. Only if I’m trying to disappear do I aim for normality. All of this points towards a conclusion: that most women feel “abnormal” in regard to their sexual selves, and with a negative connotation. This is unfortunate news.Mechanistic AnalogiesThe second thing I’m struck by in the book is the author’s use of mechanical analogies. Women are living organisms with a high degree of complexity. Often in the book I feel as though Nagoski oversimplifies women, turning them into machines. An example: her most frequently used analogy is that of accelerator and brake. When you think of these two terms, what image comes to mind? For me, it is a car. Regardless of the utility of this analogy, there are some significant hazards of thinking of a woman as a car, not least of which is that it then has a driver that is necessarily not the car. The one analogy in the book that I enjoy is that of a woman’s sexuality as a garden. Nagoski looks at different biomes and explores diversity through this analogy. Like women, gardens are living systems.Understanding Women Through MenThe third striking aspect of the book is that Nagoski begins with indictment of the way that female sexual education is taught through a male lens—and then goes to explain everything by the analogies to male anatomy and response. In other words, the presentation of this books appears to reinforce (rather than counteract) this narrative. That said, I did learn some fascinating things. For example, that there are “homologues” for every aspect of male and female genitalia.Female Orgasm as Non-EvolutionaryThe fourth surprising aspect of this book is that Nagoski states that the female orgasm is evolutionarily unnecessary (as opposed to the male orgasm, which is associated with sperm). She notes that her students don’t like this story—and I can understand why!Science and ValuesThe fifth oddity is that the book ultimately aims to change the way that women feel about their sexuality, but attempts to do so through science. There is incongruity to this approach; good science is unbiased. On the other hand—values, by their nature, are biased. So the reader is left wondering—what happens if the science veers off in another direction, and if, in a generation, we’ll realize that women should feel poorly about their sexuality? By fastidiously citing the science, Nagoski undermines her aim of reassuring women of their own worth and own experience. Both sexual science and sexual values are important, but to try to further one with the other denigrates both.ContextIf there’s one thing I’ve learned from this book, it is about the importance of female context. Eighty-five percent of women have responsive desire, meaning that becoming turned on is a phenomenon emergent from their context (psychological environment, physical environment, relational environment, etc.). There is an aspect of hazard that Nagoski overlooks in her exploration of this topic (possibly because the book was written before the #MeToo era). Responsive desire is a contributing factor to why we have stereotypes surrounding that men initiate sexual advances, and also a contributing factor to the ways in which men persist even after receiving no for an answer.In conclusion, there were a number of aspects of this book that I found distracting, but ultimately it was an interesting read and I did learn more about female sexuality.